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What Becomes of the Brokenhearted?

Man sitting alone on a park bench.

Broken heart syndrome is real, and cardiologist Mark Wiley, MD, of The University of Kansas Health System in Kansas City explains why

Musicians, artists and other entertainers owe much of their success to heartache. Volumes have been written about it; countless scores have been composed. The narrative of love and loss is a story we never seem to grow tired of.

But while the phrase "brokenhearted" is typically used to describe a person's emotional state, in the clinical world, it can refer to a real medical condition sometimes called broken heart syndrome.

"The clinical name is stress-induced cardiomyopathy," says cardiologist Mark Wiley, MD, at The University of Kansas Health System. "The other name is takotsubo cardiomyopathy – referring to the pot-like shape of the affected heart, which resembles a takotsubo, or Japanese octopus trap."

The history of broken heart syndrome

Broken heart syndrome was first described by a researcher in Japan in 1990 and was reported in the United States in 1998. Today, its cause is still not well understood. According to Dr. Wiley, it is believed to be triggered by the surge of adrenaline hormones released during an acute stress event, such as the loss of a loved one. The excess hormones damage the heart muscle and make it difficult for the heart to pump blood. But doctors have a hard time determining why some events trigger the condition while others don't.

"It could be a death in the family or a sickness or illness," Dr. Wiley says. "I've seen it in someone who lost their home."

One of the most alarming aspects of broken heart syndrome is that it occurs in individuals with an otherwise healthy heart and no prior history of a heart condition. An article in Circulation, a journal published by the American Heart Association, states that the illness is seen most often in women older than 50. Only 10% of cases are men.

"Most people come in with a completely normal heart, but we find that their heart function has declined," Dr. Wiley says. "Not everyone develops the disorder, but some people may be more sensitive to it."

Warning signs, treatment and outlook

Symptoms of broken heart syndrome are often similar to a heart attack and can include chest pain, shortness of breath and sweating. But unlike a heart attack, broken heart syndrome does not result from blocked arteries. Proper diagnosis requires an echocardiogram, which allows physicians to see the heart structure and function to rule out other causes.

Complications that can result from broken heart syndrome include heart failure and heart rhythm disorders. Most people don't experience long-term damage, but some may develop permanent scarring on the heart. In unusual cases, it can be fatal. However, Dr. Wiley says that broken heart syndrome is relatively rare and most people make a complete recovery.

"In the short term, you worry about managing heart failure and heart arrhythmia," says Dr. Wiley. "But typically, it's just temporary and the heart repairs on its own."

There is no specific treatment for broken heart syndrome, but it commonly requires a few days in the hospital and medications that help the heart muscle heal. Heart function improves within a few days and is usually normal within a few weeks," Dr. Wiley says.

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